West Midlands Ambulance Service bosses said they were preparing for a even bigger walkout than a strike in October, which saw half of workers stand down over disputes about money and shift breaks.

Other health professionals who are members of unions including Unison, Unite, Royal College of Midwives, Society of Radiographers and the British Association of Occupational Therapists will also be taking part.

The strike will be followed with some members following ‘action short of strike’ procedures, where they will not work through their legally entitled breaks until November 30.

Franco Buonaguro, Unison’s Regional Head of Health in the West Midlands, said: “NHS members don’t take action often or lightly and moving to a second stage is not an easy decision.”

Ambulance are warning residents to only dial 999 if absolutely necessary during the strike.

West Midlands Ambulance Service cover is being reduced as paramedics walk out today for four hours of NHS strikes in a national dispute with the Government over pay.

It means non-emergencies won’t get immediate responses, if at all, during the action which ends at 11am.

Picket lines are being staged across Coventry and Warwickshire and people are being told to expect delays.

WMAS assistant chief ambulance officer Mark Gough said: “There will be significant delays, people may have to wait up to four hours or there may not be an ambulance response at all for the minor and non-life-threatening calls that we receive.

“For example, people who dial 999 and are unsure of what the problem is, people who dial 999 with a minor fracture such as a broken wrist or a sprain, non-severe blood loss, abdominal pain or generally feeling unwell.

“These are the types of 999 calls that may not receive a response immediately or at all.”